Fan Min, Zhao Xia, Wang Sheng-Li, Zhang Xin-Qiong
School of Nursing, Anhui Medical University, Hefei, Anhui, China.
Acta Diabetol. 2025 May 22. doi: 10.1007/s00592-025-02512-4.
The adverse effects of excessively short or long sleep duration on diabetes have been confirmed in previous studies. However, there is a lack of research on the factors associated with sleep duration in diabetic patients, and this study aims to identify the factors associated with sleep duration in diabetes mellitus.
This study collected data from 2116 middle-aged and elderly individuals with diabetes mellitus who were surveyed by the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2015. Sleep duration was assessed based on patient self-reports, defined as the total amount of sleep patients obtained on average at night over the past month (average nightly sleep duration), it was categorized into short sleep duration (< 6 h), adequate sleep duration (6-9 h) and long sleep duration (> 9 h). Stepwise multivariable multinomial logistic regression was used to explore the associated factors related to short sleep duration (< 6 h) and long sleep duration (> 9 h), using adequate sleep duration as the reference.
The mean self-reported sleep duration in the study sample was (6.34 ± 1.86) hours, with 66.6% reporting adequate sleep duration, 29.6% short sleep duration, and 3.8% long sleep duration. Short sleep duration was positively associated with older age, having low level of education, no health insurance, poor sleep quality, short napping time, and poor self-reported health status. The probability of short sleep duration was lower among good sleep quality (OR = 0.14; 95%CI = 0.11-0.18), good self-reported health status (OR = 0.62; 95%CI = 0.44-0.88). Long sleep duration was positively associated with being male, never smoked, good sleep quality, and traditional Chinese medicine treatment. Long sleep duration was negatively associated with the cognitive function score (OR = 0.94; 95%CI = 0.90-0.99), and having one comorbidity (OR = 0.42; 95%CI = 0.20-0.87).
Sleep duration was influenced by a combination of factors among middle-aged and elderly patients with diabetes in China. The study suggested that we should focus on key populations, such as older adults, individuals without health insurance, those with poor sleep quality, low cognitive function and poor self-reported health status, to promote healthy sleep.
既往研究已证实睡眠时间过短或过长对糖尿病的不良影响。然而，关于糖尿病患者睡眠时间相关因素的研究较少，本研究旨在确定糖尿病患者睡眠时间的相关因素。
本研究收集了2116例中老年糖尿病患者的数据，这些患者于2011年和2015年接受了中国健康与养老追踪调查（CHARLS）。睡眠时间根据患者自我报告进行评估，定义为患者过去一个月平均每晚的总睡眠时间（平均夜间睡眠时间），分为短睡眠时间（<6小时）、充足睡眠时间（6 - 9小时）和长睡眠时间（>9小时）。采用逐步多变量多项逻辑回归，以充足睡眠时间为参照，探讨与短睡眠时间（<6小时）和长睡眠时间（>9小时）相关的因素。
研究样本中自我报告的平均睡眠时间为（6.34±1.86）小时，66.6%的人报告睡眠时间充足，29.6%的人睡眠时间短，3.8%的人睡眠时间长。短睡眠时间与年龄较大、教育程度低、无医疗保险、睡眠质量差、午睡时间短以及自我报告的健康状况差呈正相关。睡眠质量好（比值比[OR]=0.14；95%置信区间[CI]=0.11 - 0.18）、自我报告健康状况好（OR=0.62；95%CI=0.44 - 0.88）的人群中，短睡眠时间的概率较低。长睡眠时间与男性、从不吸烟、睡眠质量好以及接受中医治疗呈正相关。长睡眠时间与认知功能评分呈负相关（OR=0.94；95%CI=0.90 - 0.99），与患有一种合并症呈负相关（OR=0.42；95%CI=0.20 - 0.87）。
中国中老年糖尿病患者的睡眠时间受多种因素综合影响。该研究表明，我们应关注重点人群，如老年人、无医疗保险者、睡眠质量差者、认知功能低者以及自我报告健康状况差者，以促进健康睡眠。
